Part D Stand-alone Drug Plans
Medicare Part D Drug Plans provide coverage for medications typically purchased at a pharmacy.
In our opinion Medicare Part D Drug Plans leave a lot to be desired. Every year the most frustration and complaints we hear come from the Part D plans. Formularies, drug pricing, prescriptions change throughout the year but beneficiaries are stuck until Open Enrollment. Add to that the "coveage gap" in the middle of the plan, commonly known as the "donut hole" and you have plans that are poorly designed, unfair and confusing.
That said, as of 2000, everyone over age 65 is required to have "creditable drug coverage" or be penalized for not having it. Once assessed, the penalty is permanent! So, while Part D coverage is not required, prescription drug coverage is (usually from an Employer plan) or you will be penalized for life if you ever opt in!
Interestingly, while the Federal Government requires you to have drug coverage they do not supply it. Part D plans come from private insurance companies who participate in the program and must cover at least one drug in every category. This does NOT mean that every drug is covered by every carrier or that your drug is covered by a more expensive plan!
In most zip codes there are over 30 Part D Drug Plans to choose from!
The way to chose a Drug Plan is based upon 3 factors:
- Your home zip code
- Your medications - no drug plan covers all drugs - different tiers for same drug
- Your preferred pharmacyy
They range in price from $7/mo to around $150/mo!
What makes a drug plan right for you is based upon the 3 criteria above. Nothing else. A $100/mo Drug Plan is only better than a $25/mo plan IF it saves you money!
Many people make the mistake that a smaller premium saves money, or conversely, that a more expensive plan will save money. Both can be true, or not! In some cases a much higher premium has far lower drug co-pays (and/or no deductible). In other cases, a lower premium has a lower tier for a specific drug than the higher priced plan.
Part D Drug Plans are complicated. They also change each year, along with the prescriptions you take. For that reason, we cannot emphasize enough the importance of...CHECKING YOUR DRUG PLAN EACH YEAR DURING OPEN ENROLLMENT!!! If you miss Open Enrollment you may be stuck for an entire year!
Some things to be aware of with Medicare Part D plans:
- The cheapest may not be the cheapest and the most expensive may not be the best!
- Many have preferred pharmacies that will save you money if you fill your scripts there.
- If you can find your drugs cheaper elsewhere (ex. GoodRx, Canada, etc.) you are under NO obligation to use your Part D Drug Plan.
- Even if you do not take any medications the coverage is required.
- There are many programs to assist with drug costs based on income. If you think you may qualify for some apply. The most they can say is no.
- The Donut Hole
Need help choosing/checking a Part D Drug Plan? Click the link below, provide the necessary information and we can recommend the best plan for you and compare it to your current plan to show you why it makes sense to change plans.